Unequal Coverage by Heide Castañeda Jessica M. Mulligan

Author:Heide Castañeda,Jessica M. Mulligan
Language: eng
Format: epub
Publisher: New York University Press

6

Uninsured in America

Before and After the ACA

SUSAN SERED

Two Stories

Denise

Denise and her husband have worked hard—and overcome many obstacles—to build a good life together in central Illinois. The best job Denise ever had was at the Caterpillar machinery plant, where she worked for eight years. During that time, she enjoyed excellent benefits, including good health insurance with dental care and full coverage for their three children. When she became pregnant in 1991, she was working in the plant’s paint shop. The work involved cleaning out the insides of large iron vats. Leaning into a vat, she bumped her stomach into a handle, causing a miscarriage. At the same time, the ongoing strain of the paint shop work injured her back. Her doctor told her to stay home from work until she felt fully recovered from both the miscarriage and the back injury. But before the doctor released her for work, Caterpillar insisted that she return to the plant. She was fired when she told them that she was still unable to work.

After the Caterpillar job, Denise worked at a series of jobs as a nurse’s assistant, a profession that she loves. However, these jobs involved lifting patients for bathing and toileting, which exacerbated her back problems. None of these jobs lasted for long and none provided health insurance. By the 2010s the medical bills had piled up and Denise did not see a way out. But then, “The year [2013] Obamacare was announced we got it right then.”

In 2015 Denise’s health was good; she was steadily employed as a nurse’s aide at a job where she felt valued; she had become active in her church’s choir and youth ministry; and she and her husband had a lovely home where they looked after rotating cohorts of grandchildren.

Bridget

Bridget, a white woman in her early thirties, used to work as a nurse’s aide. While the salary was low and the job did not provide health insurance, it paid enough for her to rent an apartment for herself and her children. Then her life fell apart. A decade ago she took the fall for her former husband’s drug dealing (he bullied and threatened her into acquiescing) and she went to prison. When she came out, she committed the unforgiveable Mississippi sin of falling in love with a black man, and her family cut her off. In 2015 she and her boyfriend were living as squatters in a collapsing, semi-abandoned building. She wanted to work, but due to her prison record could no longer obtain employment as a nurse’s aide. And she’d lost custody of her children and thus her own eligibility for Medicaid.

A diabetic, Bridget no longer had access to medical care. “I manage it by keeping candies and juice in the house for when I feel I need it, when my fingertips are numb [that is, she feels her blood sugar is too low]. When it’s bad I go to the hospital. They give me a shot.” Several months before the 2015 interview she suffered a second-trimester miscarriage.

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